[Prognosis of local primary breast carcinoma under current therapy]

A retrospective study is presented on 225 selected patients with local primary carcinoma of the breast treated from 1963 to 1973 at the Surgical Clinic of the Cantonal Hospital, St. Gallen, Switzerland. All patients were under 70 years old. The results are compared of our two therapies, namely radical mastectomy of Halsted and a modified radical mastectomy consisting of mastectomy with dissection of the axilla but without removing the pectoral muscle. Both operations were followed by postoperative irradiation. In view of the short postoperative interval after modified radical mastectomy (from 1969), a five-year diseasefree survival is indicated. There was no statistically significant difference between the two therapies. Depending on age, patients with histologically negative lymph nodes of the axilla had a probability of 45-60% for 5-year diseasefree survival, against only 15-40% for those with positive axillary lymph nodes. The quality of survival is deemed important, and the authors therefore recommend the modified radical mastectomy, which disfigures a woman less than the Halsted operation.